Health Care Quality Indicators Project - 2006 data collection update report
Edward Kelley, Sandra Garcia Armesto, Maria Luisa Gil Lapetra, Lihan Wei and the Members of the HCQI Expert Group
OECD HEALTH WORKING PAPERS NO. 29, 2007
Organisation for Economic Co-operation and Development,
This report is an update to the OECD Health Working Paper No. 22, Health Care Quality
Available online as PDf file [165p.] at: http://www.oecd.org/dataoecd/57/22/39447928.pdf
“….This paper reports on the results of that second round of data collection. Data is presented here on an augmented indicator set considered fit for the purpose of making international comparisons on quality of health care. The data is comprised of 19 indicators (17 initial indicators plus 2 new ones). The paper also presents the data provided on 7 other indicators that are not yet considered fit for international comparison. In this round of data collection, data were reported by 32 countries…..”
“…The indicator selection criteria applied in the process of creating the original and current indicator list are summarised here. For an indicator to be a useful tool for evidence-based policy decisions, two conditions should be met. First, it has to capture an important performance aspect. Second, it must be scientifically sound.
The importance of an indicator can be further broken down into three dimensions:
• Impact on health. What is the impact on health associated with this problem? Does the measure address areas in which there is a clear gap between the actual and potential levels of health? The impact on health is quantified where data is available for each indicator by using mortality and morbidity estimates from the World Health Organization for the ‘EURO A’10 group of countries, (
• Policy importance. Are policymakers and consumers concerned about this area? Although this dimension is difficult to quantify objectively, the cost associated with the condition covered by each indicator is used to indicate the economic importance related to each indicator. Where suitable evidence on costs exists, it is also presented for each indicator.
• Susceptibility to being influenced by the health care system. Can the health care system meaningfully address this aspect or problem? Does the health care system have an impact on the indicator independent of confounders like patient risk? Will changes in the indicator give information about success or failure of policy changes? This dimension is discussed based on a review of the relevant literature demonstrating that the health system can influence each indicator.
The scientific soundness of each indicator can also be broken down into three dimensions:
• Face validity. Does the measure make sense logically and clinically? The face validity of each indicator in this report is based on the basic clinical rationale for the indicator and on past usage of the indicator in national or other quality reporting activities.
• Content validity. Does the measure capture meaningful aspects of the quality of care? Content validity is assessed through a literature review of studies relevant to each indicator.
• Reliability. Does the measure provide stable results across various populations and circumstances? Reliability of each indicator is assessed through a literature review of studies assessing the stability of results across populations or circumstances.
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